Is the AA profession gaining ground?

Specialties CRNA

Published

Another thread peaked my interest on this issue. How fast is the AA profession gaining ground? I thought they were able to practice in only 2 or 3 states last year, but now it sounds like they are able to practice in 16? Will they be able to practice in even more states soon? Comments appreciated

....Yawn....

.

Ahhh... Deepz. Missed you buddy, how've you been??

I agree about their site comparing AA to CRNA's. Seems like recently they may have reduced the amount of comparisons. Just about a month ago it was all over the site though, even on the homepage. Just seems like that is what you guys promote we are just as good a CRNA's instead of really promoting what you do or how you can help provider shortages or any real data proving your claim to safety, equality or effectiveness. In other words your website really doesnt promote what you guys preach here on these forums.

Nice post Mike. I tend to be a gun slinger no diggity no doubt.

You must be looking at "the other" websites. ;) Our website, the real one, is pretty straightforward about our education and qualifications, and it goes right along with what we say here. There's actually nothing on the website about CRNA's, pro or con, except to mention the review in Cleveland comparing complication rates (no difference).

The provider shortage / rural care issue is interesting all by itself. Here's where politics get dirty, and it's not our doing. We all know there is a shortage of anesthesia providers. If there wasn't, nurse anesthesia schools wouldn't be ramping up like they are (and neither would AA schools for that matter). Yet one of the first arguments thrown up in North Carolina is that there's no shortage. Really?? I just counted up more than 90 positions posted on Gaswork.com. One of those facilities needs 14 anesthetists. And what happens after a nursing lobbyist testifies under oath in the state legislature that there is no shortage of providers? They go to the committe meeting right down the hall and beg for more money for more nursing schools and more CRNA schools because, say it with me now, there's a shortage of providers. Five CRNA schools in NC - but I guess not many of their students stay around. OMG, many of them might actually be going back HOME after they finish school, wherever home might have been. And if there is no shortage, why on earth would a sixth CRNA school be proposed for NC?

You have no argument from me that there are issues with adequate rural coverage (I've addressed the Medicare favoritism to CRNA's previously so I won't rehash that). But I love it when the claim is made that "30 counties in NC don't have an anesthesiologist". Ah, but you know that little thing about "the truth, the WHOLE truth..."? Seems as though 20 of those 30 counties don't even have a hospital or a surgery center or any type of facility that could use the services of an anesthesia provider of any flavor. Similar tactics have been used in every other state where legislation was introduced.

Georgia_AA

I like you alot. All of your posts are well written and thoughtful. Nitecap, jwk and I are all the "fire from the hip" types but you are not.

In anycase, I dont think jwk or you represent AAs in any way other than a good light. Im not a CRNA, but i stayed at a holiday inn last night. From my reading on the AA site it seems clear your association spends a good portion of its webspace comparing CRNA vs AA which suggest they advocate a more aggressive stance than you do. Thats probably why you might get some automatic assumptions about AAs from CRNA students, new CRNAs and potential CRNAs (me).

You, however, seem like a great guy (or girl) to represent the profession. Thnaks for posting.

shocked.gif

Who are you and what have you done with Deepz and Swumpgas?

Specializes in I know stuff ;).

hehehe

The two websites are quite interesting. I followed a link to an adobe file that was full of serious misinformation. It claimed that CRNA grads could take the optional national certification exam. Which I guess is true... if you wanted to actually practice after graduation.

We are not trying to close the gap. We don't want to take over the world. How many times and how many different ways do you need me to say it. While the AANA has as a major agenda the abolition of AAs nationwide, the AAAA is not interested in putting a single CRNA out of work. There in a nutshell is the difference. You want me out of the OR and unable to provide for my family. I simply want the right to work in my chosen profession anywhere I want. I don't want to put a single CRNA out of work, but I should be able to compete with you for ACT practice positions. Yes, you can fill a need in the rural areas. I will NEVER compete with you for those jobs. ACT practices, on the other hand can and should hire either practitioner interchangably with supply and demand being the major driving force in the decision.

QUOTE]

I would never wish to cause someone to be unable to provide for his family. I do willfully however, help to impose the standards for anesthesia training designed by CRNA's. Why are we supposed to welcome AA's? Yes, I would like to see the abolition of all AA programs. Does the UAW welcome foreign workers? No other profession says, "Here's your competion, now play nicely together.". If you want to become an anesthetist, go to nursing school. Spend your time in the ICU. Go to CRNA school. Viola! You now have 50 state recognized credentials and are free from your legislative worries of the AA. Plus you now have the backing of 30, 000 brothers and sisters.

Since this debate is frequent, I'll put on a flame suit and say...

I did not voice any negatives about AA's. This is my opinion of CRNA preservation.

I would never wish to cause someone to be unable to provide for his family. I do willfully however, help to impose the standards for anesthesia training designed by CRNA's.

That's fine - You're free to impose your own standards on yourself and YOUR profession. Why on earth do you think it's reasonable to impose your standards on MY profession? And have you even read the standards for my profession? They're available in the public domain, unlike the standards for CRNA programs which are hidden behind the firewall and members-only section of the AANA website. Why is that?

And BTW, those "standards" for CRNA's are a relatively new thing in the long history of CRNA's, both the one for a BSN and the year of critical care experience. And oh, I just love this, right there at the very top of the CRNA section of allnurses.com :

Education: While 37 percent of the nurse anesthetists received their nurse anesthetist educational preparation through a master’s program, 58 percent received their educational preparation through a post-RN certificate.

Like Sgt. Joe Friday says - just the facts ma'am.

Yes, I would like to see the abolition of all AA programs. Does the UAW welcome foreign workers? I'll put on a flame suit and say...

I did not voice any negatives about AA's. This is my opinion of CRNA preservation.

That's not negative? Hmmmmm

Specializes in Anesthesia.
........That's not negative? Hmmmmm

....yawn....

.

That's fine - You're free to impose your own standards on yourself and YOUR profession. Why on earth do you think it's reasonable to impose your standards on MY profession? And have you even read the standards for my profession? They're available in the public domain, unlike the standards for CRNA programs which are hidden behind the firewall and members-only section of the AANA website. Why is that?

And BTW, those "standards" for CRNA's are a relatively new thing in the long history of CRNA's, both the one for a BSN and the year of critical care experience. And oh, I just love this, right there at the very top of the CRNA section of allnurses.com :

Education: While 37 percent of the nurse anesthetists received their nurse anesthetist educational preparation through a master's program, 58 percent received their educational preparation through a post-RN certificate.

Like Sgt. Joe Friday - just the facts ma'am.

That's not negative? Hmmmmm

It is true of the post-RN certificates but the profession has taken significant strides to advance the education and status. A friend of mines dad is a CRNA of 35yrs. Claims back in the day CRNA's made squat and that the profession has and is changing rapidly. Its crazy some of this stuff they used to do when he first got out. Listen both professions I would bet have fairly equal didactic education. Or they should at least. What is called into question is not the didactic education but the lack of clinical experience and hands on pt care before you are pushing dangerous drugs and shoving tubes and lines in people, and making critical descisions. You can make the aurgument that most AA's have some sort of clinical experience which yes was prob true 10yrs ago but as programs expand more people with non hlth care, no science degrees are entering your profession. As I claimed I have met AA students online with elementary ed, civil engineering and psychology undergrad degrees. And taking Organic, Bio chem, which i took or calc doesnt make up for this lack of experience or exposure to actually pt problems.

Yeah the first RN's that put people to sleep using drip ether methods for DR. Mayo werent masters prepared. Nor where the catholic nuns that went to europe in WWI to anesthetize ours and french soldiers at military bases. Masters prepared nurses prob didnt even exist when Alice freaking McGaw had already put 14,000 pts to sleep with drip ether in the early 1900's, Nor did they when Hodgins put over 10,000 pts to sleep using N2O, Ether tech.

So they werent masters prepared and many still arent and it doesnt seem to be effecting the level of care at present. If the study you cite is true of there being no difference b/t the 2 in that Ohio practice Im sure at least a few of those CRNA's to make the comparisson to AA's were merely post grads certificates. A title sometimes can be just that.

The shape and mentality of all anethesia providers is and will continue to change. AA's will proliferate, CRNA's will proliferate and attempt to award Its than the Masters, and MD's are claiming that a "new bread" of anesthesiologists will enter the work force in the future. Not sure who they mated to come up with this new species but it will be interesting to see.

It is true of the post-RN certificates but the profession has taken significant strides to advance the education and status. A friend of mines dad is a CRNA of 35yrs. Claims back in the day CRNA's made squat and that the profession has and is changing rapidly. Its crazy some of this stuff they used to do when he first got out. Listen both professions I would bet have fairly equal didactic education. Or they should at least. What is called into question is not the didactic education but the lack of clinical experience and hands on pt care before you are pushing dangerous drugs and shoving tubes and lines in people, and making critical descisions. You can make the aurgument that most AA's have some sort of clinical experience which yes was prob true 10yrs ago but as programs expand more people with non hlth care, no science degrees are entering your profession. As I claimed I have met AA students online with elementary ed, civil engineering and psychology undergrad degrees. And taking Organic, Bio chem, which i took or calc doesnt make up for this lack of experience or exposure to actually pt problems.

Yeah the first RN's that put people to sleep using drip ether methods for DR. Mayo werent masters prepared. Nor where the catholic nuns that went to europe in WWI to anesthetize ours and french soldiers at military bases. Masters prepared nurses prob didnt even exist when Alice freaking McGaw had already put 14,000 pts to sleep with drip ether in the early 1900's, Nor did they when Hodgins put over 10,000 pts to sleep using N2O, Ether tech.

So they werent masters prepared and many still arent and it doesnt seem to be effecting the level of care at present. If the study you cite is true of there being no difference b/t the 2 in that Ohio practice Im sure at least a few of those CRNA's to make the comparisson to AA's were merely post grads certificates. A title sometimes can be just that.

The study in Cleveland covered about 45,000 cases - every case done that involved any AA or CRNA in their hospital system for 2-3 years. CWRU has both an AA and CRNA program, so it makes an excellent comparison between the two professions.

Like I said - the BSN (or other degree) and critical care requirement is recent history, not Florence Nightingale. Early to mid 90's. And even those requirements are open to interpretation and flexibility at the individual program level. According to the AANA website, the requirement is BSN or "other appropriate baccalaureate degree". So it doesn't actually have to be a BSN. It could be an associates degree RN that has finished their bachelor's degree in a field other than nursing.

And it's not actually a critical care requirement - it's "acute care". For some it's true ICU experience. Others it's ER, or NICU, or even PACU. And although many nurse anesthesia students have a lot of experience, many do not. I know several who have been accepted into their programs at a point where they had only three months of experience, and it was just assumed that they'd have that full year in by the time they started anesthesia school.

You think the experience is necessary - we don't. It helps, granted, but it's not a requirement. We would rather have the student with the requisite knowledge of the sciences - after all, anesthesiology is a science. And we're talking hard science, not the freshman level survey chemistry courses I've seen described as being taken in various threads on this website. Calculus Physics, not intro to physics. Organic. Biochem. Sure, some nurse anesthesia students have these. I would guess most do not. Why? Because things like organic and biochem and calc physics are hard to cram into a BSN program with all those nursing classes. The college major really doesn't matter - if you don't have the requisite science classes, you're not getting in a program. There are plenty of psych, education, and business, and lets not forget, even a few nursing majors getting into medical school as well, but there's not one that gets in without a broad foundation in hard science. And of course a nursing degree has never been a requirement for medical school - why should it be for anesthesia school?

Z, sorry we're boring you - go back to sleep.

The study in Cleveland covered about 45,000 cases - every case done that involved any AA or CRNA in their hospital system for 2-3 years. CWRU has both an AA and CRNA program, so it makes an excellent comparison between the two professions.

Like I said - the BSN (or other degree) and critical care requirement is recent history, not Florence Nightingale. Early to mid 90's. And even those requirements are open to interpretation and flexibility at the individual program level. According to the AANA website, the requirement is BSN or "other appropriate baccalaureate degree". So it doesn't actually have to be a BSN. It could be an associates degree RN that has finished their bachelor's degree in a field other than nursing.

And it's not actually a critical care requirement - it's "acute care". For some it's true ICU experience. Others it's ER, or NICU, or even PACU. And although many nurse anesthesia students have a lot of experience, many do not. I know several who have been accepted into their programs at a point where they had only three months of experience, and it was just assumed that they'd have that full year in by the time they started anesthesia school.

You think the experience is necessary - we don't. It helps, granted, but it's not a requirement. We would rather have the student with the requisite knowledge of the sciences - after all, anesthesiology is a science. And we're talking hard science, not the freshman level survey chemistry courses I've seen described as being taken in various threads on this website. Calculus Physics, not intro to physics. Organic. Biochem. Sure, some nurse anesthesia students have these. I would guess most do not. Why? Because things like organic and biochem and calc physics are hard to cram into a BSN program with all those nursing classes. The college major really doesn't matter - if you don't have the requisite science classes, you're not getting in a program. There are plenty of psych, education, and business, and lets not forget, even a few nursing majors getting into medical school as well, but there's not one that gets in without a broad foundation in hard science. And of course a nursing degree has never been a requirement for medical school - why should it be for anesthesia school?

Z, sorry we're boring you - go back to sleep.

Anyone that is taking and passing the didactic couse work in CRNA/AA school should be able to memorize functional groups, bio chem pathways, and physics laws JPP. The aurguement is weak saying that that the hand full of classes you name makes you guys anymore quailfied. It should tell you something about these classes if an elementary ed 4th grade teacher can go back to school and do well enough in them to get into AA school. Anyone can do it. My sister who has a degree in marketing can most likely pass these courses if she studied hard enough. Anyone can have this broad science base. The researchers I chat with everyday prob have a broader science base than most MD's. Does that mean that they can automatically spend a yr in the OR and be a competent anesthetist. Maybe so, probrably not. Life I said anyone can take these courses. Not anyone can have real hands on experience and know what the faq is going on when the shiznit is hitting the fan. Sorry my Marketing degreed sister would not have a clue if you stuck her in a clinical descion making situation, nor would my many beloved PA student friends that I have taken several classes with. Thats where the gap is. And no it is not required to be a nurse to goto med school.. They do a ton of clinical rotations and years of residency to do what they do. And the MS 1 or 2 is not anesthetizing pts either now.

The problem is that funtional groups, bio chem, pathways, and 2 page calc problems are not gonna help you much things are critical, things are changing rapidly before your eyes and your attending MD is tied up a few suites down with a pt that is crashing. Your not gonna be thinking yes thats ether with a Fl- and Br- group, or it must be a pyruvate kinase problem here that is causing my pressure to be in the toilet. You need critical thinking skills, you need to assess, think and react and reassess. You guys im sure have a wealth of book knowledge and you should but critical thinking skills are something that is learned with experience and time. And the very RN's you speak of that get in as quick as that in less than a year many times struggle all around, I have seen it man. Now yes the AA with 10yrs experience is im sure just as good as the CRNA. this aurgument I believe is geared more to students and relatively new practitioners. I will bet that half the MD's you see tomorrow could spit out half those bio chem pathways and could do to many calc problems they used to do. But they have sure become way better clinicians as they have built upon their experiences. these critical thinking and decision making skills stay with you man, half the other stuff you have memorized you forget but can easily pick up a book and memorize it again. Yes my classmate husband is a CT fellow with 2 yrs left and he could remeber only bits and peices of bio chem paths and didnt even know some had changed.

So they werent masters prepared and many still arent and it doesnt seem to be effecting the level of care at present.

And many AAs aren't nurses before beginning their anesthesia training and it doesn't seem to be affecting the level of care that THEY provide. So why are you right and I'm so wrong. OF COURSE, it's not the degree that makes the provider a great clinician. I actually agree with you on that point. Masters prepared or certificate, it's the persons intellect and work ethic that ultimately determines how they'll function in the stress filled and often fast paced environment of the OR.

Let me ask you this - where did you get your experience before you started taking care of patients in the ICU? I mean, surely you weren't pushing all of those dangerous drugs and titrating drips and taking care of those incredibly sick patients with no prior clinical experience were you? Maybe all ICU nurses should be nursing assistants first so that they will have clinical experience before entering the acute care environment of the ICU. Oh wait - you went to NURSING SCHOOL with didactic and clinical rotations BEFORE you entered the ICU as a bonafide licensed practitioner. AAs get 2 solid years of hands-on direct patient care proctored by practicing AAs and MDAs before they are ever left alone in the OR.

We've already proven that you don't have to have a nursing background to be an anesthetist. I think that it just galls you guys that there is a shorter path to the same goal. Just because you have to jump through all of those hoops that your nursing profession places in front of you, doesn't mean that I have to.

I maintain that each and every one of you great CRNAs would have been just fine had you entered CRNA school right out of nursing school. Maybe not right away, but ultimately - yes. I know it, and I think you know it too - you just can't say it.

+ Add a Comment